Rapid advances in digital technologies are creating exciting possibilities to deliver quality, affordable care to Australia’s growing population of senior citizens, allowing them to remain where they want to be – in their homes.
Mobile devices, apps, wearables and other consumer-driven technologies are driving demand for easier access to real-time information, coinciding with the maturing of enterprise technologies around big data analytics and artificial intelligence (AI).
Australia faces a number of significant hurdles on this journey, including outdated and ‘siloed’ information systems, poor awareness, lack of industry cooperation, a perennially sick NBN and lumbering MyHealth digital records program.
This is despite a growing and compelling body of research showing systems and processes for telemonitoring and telehealth can deliver huge benefits to patients, while reaping significant financial savings.
Last year the CSIRO published the results of the largest telehealth trial ever undertaken in Australia to determine the cost and care benefits to older Australians living with chronic disease using digital technologies supporting home care.
‘Home Monitoring of Chronic Disease for Aged Care’, the cohort study, was conducted at six sites in five states and territories, each with 25 test patients and 50 control patients, in both public and private settings. Monitoring was conducted between 2013 and 2014, with some patients monitored continuously for as long as 18 months, with the majority monitored for 9-15 months.
The results showed consistently significant benefits across key indicators including quality of care, length of hospital visits, mortality, and cost.
46.3% reductions in rate of MBS expenditure (savings $611-$657)
25.5% reduction in rate of PBS expenditure (savings $44-$354)
53.2% reduction in the rate of admission to hospital (reduction of 0.22 – 1.0 hospital admissions)
75.7% reduction in the rate of length of stay (reduction in LOS of 7.3 – 9.3 days)
> 40% reduction in mortality
> 83% user acceptance and use of telemonitoring technology
> 89% of clinicians would recommend telemonitoring services to other patients
In one case, an elderly man had major heart surgery the previous year, joining the CSIRO trial shortly after. Thanks to regular monitoring of his vital signs via digital telemonitoring system, doctors were alerted instantly to certain anomalies, taking action to address problems that otherwise might have had fatal consequences.
In another case, an elderly woman had a number of chronic health conditions forcing her husband to be a full-time carer, in addition to his wife needing to visit doctors two to three times a week. These visits have now been paired back to once every three weeks.
One of the report’s lead authors, Dr Rajiv Jayasena, said the study marks an important point in the evolution of Australia’s healthcare sector, and should spur CIOs and other IT professionals working in the sector to reassess their current approaches, attitudes and supporting infrastructure.
Jayasena said healthcare organisations need to view digital technologies through the lens of “coordinated care”, a reflection of the huge complexities involved in the sector. Key to this is having a plan for “risk stratification”, an approach he said has already proved itself in busy call centres managing big spikes in traffic.
“Nurses need the ability to divert their attention to the most [in-need] people in that day,” Jayasena said, adding that expects senior nurses trained to use digital tools should be able to manage as many as 100 patients at a time.
Consultancy firm Deloitte, estimates that by 2018 there will be 1.7 billion smartphone users – half of the expected total of 3.4 billion – will have downloaded mobile health apps, which will have capabilities beyond today’s apps, including being able to collect and interpret complex data sets spanning personal and real-time health information, diet and environmental factors. And the ability for individuals to own and share genomic information isn’t too far off.
In the wearables space, development of smarter and smaller biosensors that can be inserted into watches, on and under the skin, or even swallowed, suggest possibilities to monitor complex biological processes, such as how individuals react to specific drug doses.
Lynne Pezzullo, a partner with Deloitte Australia, said rapid advances in robotics have big implications for the future of remote digital healthcare, adding that rising demand for their solutions is one of the major drivers for the sector as a whole.
“It’s a sector now starting to reach maturity, especially in Japan,” she said, where patients – the elderly in particular – have for some time been interacting with robots for basic consultations, as well as to receive drug prescriptions.
In 2013, the FDA approved the first robot for use in hospitals, marking an important milestone for the industry.
AI is also being touted as an important piece of the healthcare puzzle in the future.
Earlier this year, Microsoft showcased its ‘triage bot’ – developed by the company in Israel – which is designed to receive simple voice messages like ‘my leg hurts’. The idea is that the bot would access a patient’s medical records, and retrieve, for instance, an image of their leg asking to indicate the point of pain, and then make recommendations for care based on their digitally-stored health information.
Other tech giants including IBM, Apple, Samsung and Google are in the race to develop effective digital health solutions in what is shaping up to be a very lucrative market indeed.
But as the race continues to develop more and more exciting, shiny tech, the real innovations that matter for healthcare are those that support a fully-integrated, digitally connected healthcare system, giving clients access to better information and ultimately more choice when it comes to making healthcare decisions.
“We will start to see better caring outcomes for ‘individuals’,” she said.
“A bit like eHarmony in the caring space”.